Abstract：Objective: To summarize the anesthesia experiences of laparoscopic pyeloureteroplasty with da Vinci robotic system in children and discuss its superiority in pediatric urologic surgery and the complexity of anesthesia management. Methods: Twenty patients who underwent robotic-assisted laparoscopic pyeloureteroplasty were enrolled in the study, their anesthesia process and clinical records were analyzed, including PETCO2, arterial blood gas analysis, anesthesia time, operation time, hospital stay and pain evaluation after operation, and compared to those of children who received open pyeloureteroplasty. Results: Twenty robotic-assisted operations have been performed in our hospital. The average age of the children was 6.4 years. The total of anesthesia time (190.3±24.6 min) and operation time (162.7±12.5 min) were longer than open laparotomy. The PaCO2 and PETCO2 were significantly elevated at the start of pneumoperitoneum as compared with those at the baseline before pneumoperitoneum (P<0.05). The pH value was significantly decreased 1 h after pneumoperitoneum as compared with that at the baseline before pneumoperitoneum (P<0.05). These situations were improved after ventilator adjustments. The blood loss, hospital stay and pain score were (136.5±14.3) mL, (5.6±1.0) days and (3.8±1.3) respectively. Conclusions: Robotic-assisted pediatric urologic surgery produced many advantages, such as less trauma, less blood loss, clearer operation field, shorter postoperative hospital stays and milder postoperative pain. But it is more likely to have acid-base imbalance compared with laparotomy, and puts forward higher requirements for anesthetic management.
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